Assessment of the Predictive Value of a Bowel Symptom Questionnaire in Identifying Perianal and Anal Sphincter Trauma After Vaginal Delivery

Frudinger, Andrea; Halligan, Steve; Bartram, Clive I.; Spencer, John; Kamm, Michael A.; Winter, Raimund

doi:10.1007/s10350-004-6651-9

Cited by 12 publications

(10 citation statements)

References 33 publications

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“…Frudinger et al [11] found that a bowel symptom questionnaire could predict only 57% of sphincter defects following childbirth. Anal inspection and digital rectal examination are basic assessment tools of sphincter integrity and function.…”

Section: Introductionmentioning

confidence: 99%

Predicting anal sphincter defects: the value of clinical examination and manometry

et al. 2011

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Section: Introductionmentioning

confidence: 99%

Predicting anal sphincter defects: the value of clinical examination and manometry

et al. 2011

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“…Sultan et al 20 observed that 30 percent of anal sphincter lesions were asymptomatic. Frudinger et al 19 observed that among 43.2 percent of females presenting ultrasonographic evidence of anal sphincter tears, only 27.6 percent complained of deterioration of anal continence and that among the 17.5 percent of females with anal symptoms only 17.5 percent presented ultrasonographic evidence of anal sphincter tears. It is generally agreed that anal sensation is not always correlated with low anal squeeze pressure and ultrasonographic evidence of sphincter defects.…”

Section: Discussionmentioning

confidence: 96%

“…A previous study demonstrated that only 60 percent of females with anal sphincter tear consecutive to vaginal delivery were detected using a postpartum bowel-habits questionnaire. 19 Use of a questionnaire for evaluation of anal symptoms is associated with a poor sensitivity but good specificity. Another potential problem is the understandability of the questionnaire.…”

Section: Discussionmentioning

confidence: 99%

Frequency of Persistent Anal Symptoms After First Instrumental Delivery

Mazouni

Bretelle

Battar

et al. 2005

Diseases of the Colon &Amp; Rectum

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“…Symptoms subsequent to perineal tears include flatulence incontinence, pathological urge to defecate and, more rarely, fecal incontinence with the consistency ranging from watery to firm stools. The frequency of these symptoms tends to increase over the years following the birth 7 , 8 , 9 .…”

Section: Guidelinementioning

confidence: 99%

Management of Third and Fourth-Degree Perineal Tears After Vaginal Birth. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/079, December 2020)

Kropshofer

Aigmüller²,

Beilecke

et al. 2022

Geburtshilfe Frauenheilkd

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Purpose This guideline provides recommendations for the diagnosis, treatment and follow-up care of 3rd and 4th degree perineal tears which occur during vaginal birth. The aim is to improve the management of 3rd and 4th degree perineal tears and reduce the immediate and long-term damage. The guideline is intended for midwives, obstetricians and physicians involved in caring for high-grade perineal tears. Methods A selective search of the literature was carried out. Consensus about the recommendations and statements was achieved as part of a structured process during a consensus conference with neutral moderation. Recommendations After every vaginal birth, a careful inspection and/or palpation by the obstetrician and/or the midwife must be carried out to exclude a 3rd or 4th degree perineal tear. Vaginal and anorectal palpation is essential to assess the extent of birth trauma. The surgical team must also include a specialist physician with the appropriate expertise (preferably an obstetrician or a gynecologist or a specialist for coloproctology) who must be on call. In exceptional cases, treatment may also be delayed for up to 12 hours postpartum to ensure that a specialist is available to treat the individual layers affected by trauma. As neither the end-to-end technique nor the overlapping technique have been found to offer better results for the management of tears of the external anal sphincter, the surgeon must use the method with which he/she is most familiar. Creation of a bowel stoma during primary management of a perineal tear is not indicated. Daily cleaning of the area under running water is recommended, particularly after bowel movements. Cleaning may be carried out either by rinsing or alternate cold and warm water douches. Therapy should also include the postoperative use of laxatives over a period of at least 2 weeks. The patient must be informed about the impact of the injury on subsequent births as well as the possibility of anal incontinence.

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Assessment of the Predictive Value of a Bowel Symptom Questionnaire in Identifying Perianal and Anal Sphincter Trauma After Vaginal Delivery

Abstract: A bowel-habit questionnaire will detect approximately 60 percent of females who sustain external sphincter tears after vaginal delivery.

Cited by 12 publications

References 33 publications

Predicting anal sphincter defects: the value of clinical examination and manometry

Predicting anal sphincter defects: the value of clinical examination and manometry

Frequency of Persistent Anal Symptoms After First Instrumental Delivery

Management of Third and Fourth-Degree Perineal Tears After Vaginal Birth. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/079, December 2020)

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